Form 100-Z - Uniform Straight Bill Of Lading
Download a blank fillable Form 100-Z - Uniform Straight Bill Of Lading in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 100-Z - Uniform Straight Bill Of Lading with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1NATIONAL MOTOR FREIGHT CLASSIFICATION 100-Z
RULES
(To be printed on white paper)
UNIFORM STRAIGHT BILL OF LADING
Carrier’s Pro No. ________________ _ _______
ORIGINAL—NOT NEGOTIABLE
Shipper’s Bill of Lading No. _________ _ ______
Consignee’s Reference/P.O. No. _____ ___ _ ___
Name of Carrier ______________ _____________________________________________
Carrier’s Code (SCAC)________________ ___
RECEIVED, subject to individually determined rates or contracts that have been agreed upon in writing between the carrier and shipper, if applica-
ble, otherwise to the rates, classifications and rules that have been established by the carrier and are available to the shipper, on request:
From __________________________________________________________________________________ Date ________ _ ________________
Street _______________________ City ________________________ County ___________________ State ________________ Zip __________
the property described below, in apparent good order, except as noted (contents and condition of contents of packages unknown) marked, consigned, and destined as shown below,
which said carrier agrees to carry to destination, if on its route, or otherwise to deliver to another carrier on the route to destination. Every service to be performed hereunder shall be subject to
all the conditions not prohibited by law, whether printed or written, herein contained, including the conditions on the back hereof, which are hereby agreed to by the shipper and accepted for
himself and his assigns.
Consigned to _______________________________________________________________________________________________________________
On Collect on Delivery Shipments, the letters “COD” must appear before consignee’s name.
Destination Street ____________________________________________________________________________________________________________
City ___________________________________________ County ___________________________________State ________________ Zip __________
Delivering Carrier ____________________________________________________________________ Trailer No. _______________________________
Additional Shipment Information_________________________________________________________________________________________________
C.O.D. charge
Shipper
Collect on Delivery $ ________________________ and remit to: _______________________________________
to be paid by
Consignee
Street ___________________________________________ City __________________ State ______________ __
Handling
Packages
Weight
Class or
Cube
Kind of Package, Description of Articles, Special Marks and Exceptions
(Subject to
Rate Ref.
(Op-
Units
HM
No.
(Subject to correction)
Correction)
(For Info.
tional)
No.
Type
Only)
Type
Mark “X” to designate Hazardous Materials as defined in DOT Regulations.
Freight charges are PREPAID
unless marked collect.
NOTE (1) Where the rate is dependent on value, shippers are required to state specifically
CHECK BOX IF COLLECT
in writing the agreed or declared value of the property as follows:
FOR FREIGHT COLLECT SHIPMENTS:
“The agreed or declared value of the property is specifically stated by the shipper to be not
exceeding _______ per _______.”
If this shipment is to be delivered to the consignee, without recourse
on the consignor, the consignor shall sign the following statement:
NOTE (2) Liability Limitation for loss or damage on this shipment may be
applicable. See 49 U.S.C. § 14706(c)(1)(A) and (B).
The carrier may decline to make delivery of this shipment without
payment of freight and all other lawful charges.
NOTE (3) Commodities requiring special or additional care or attention in handling or stowing
_________________________
must be so marked and packaged as to ensure safe transportation with ordinary care. See
(Signature of Consignor)
Sec. 2(e) of NMFC Item 360.
Notify if problem en route or at delivery ______________ ____________________________________________ (for informational purposes only)
Name
Fax No.
Tel. No.
Send freight bill to: ______________ ________________________________________________________________________________ _______
Company Name
City
Street
State
Zip
Shipper ______________ _____________________________________ Carrier __________________________________________ __________
Per _____________________________________
Per _____________________________________
Date _______________
Shipper Certification
Carrier Certification
This is to certify that the above-named materials are properly classified,
Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and/or
described, packaged, marked and labeled, and are in proper condition for
carrier has the DOT emergency response guidebook or equivalent document in the vehicle.
transportation according to the applicable regulations of the DOT.
Per ____________________________________________________________________________ Package Nos. __________________________________
Per _________________________________________ Date __________________
Date __________________________________________________________________________________________________________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business